Marijuana As Medicine

Fact Sheets

This page contains general information on marijuana's medical use for certain ailments
as well as historical information. Specific bibliographies are located at the bottom
of this document. Visitors may also want to visit ACT's Frequently Asked
Questions (FAQ) page,

Visitors seeking more detailed information are encouraged to visit Medline and conduct a search of the
National Library of Medicine's databank.

Cannabis sativa and cannabis indica (marijuana) has a long and
distinguished history as a medicinal herb. The Chinese emperor Shen-nung was the first to
record the medical use of cannabis in 2737 B. C. Many cultures, however, have recognized
the therapeutic benefits of the cannabis plant. Among them are: India, Persia, Assyria,
Greece, Africa, South America, Turkey, and Egypt.

In Western medicine cannabis enjoyed its heyday during the 19th Century. In the late
1830s, Dr. William B. O'Shaughnessy, a British physician at the Medical College of
Calcutta, learned of cannabis and began experimenting with various cannabis preparations.
He determined the drug was safe and effective in treating rabies, rheumatism, epilepsy and
tetanus.

O'Shaughnessy published his studies in a forty page article entitled "On the
preparations of the Indian Hemp or Gunjah," in 1839. This marked the beginning of an
intensive period of study throughout Europe and America. More than 100 articles were
published between 1840 and 1900. Many prominent physicians, including Queen Victoria's
personal physician, J. R. Reynolds, studied cannabis. Reynolds declared it "by far
the most useful of drugs" in treating "painful maladies."

In America, the first extensive study of cannabis in medicine was completed in 1860 by
the Ohio Medical Society. Physicians reported success in treating stomach pain and gastric
distress, psychosis, chronic cough, gonorrhea and neuralgia.

At the turn of the century, the drug began to fall into disuse. Cannabis was difficult
to store and its extracts were variable in their effect. As new drugs were developed in
the early 1900s, cannabis was less widely used but still available by prescription and in
some over-the-counter preparations.

The Marijuana Tax Act of 1937, intended to prohibit marijuana's social use, was most
effective in prohibiting medical use of the drug. Strict regulations governing cultivation
of the plant made its production impractical. New synthetic drugs caught the fancy of
physicians and cannabis was used less frequently, Finally, in 1942, the Federal Bureau of
Narcotics convinced the U. S. Pharmacopeia to remove the drug from its listing.

In the 1970s, cannabis was "re-discovered" as a medical substance. Controlled
studies have revealed its therapeutic utility in the treatment of cancer chemotherapy
side-effects, glaucoma, and spasticity ailments. Federal regulations continue to make
research with the drug very difficult, however, and many promising areas of therapeutic
application have received little or no attention. These include: asthma, AIDS, epilepsy,
analgesic action, tumor retardation, nervous disorders, and mental illness.

Cancer chemotherapy can often prolong the patient's life by several years. In some
instances, a complete "cure" can be obtained. Unfortunately, these drugs also
have severe side-effects, most notably nausea and vomiting. Patients sometimes find these
effects so distressing they abandon chemotherapy entirely.

People with AIDS (Acquired Immune Disease) also experience these problems. Powerful
anti-viral drugs such as AZT and the new protease inhibitors can induce severe nausea,
vomiting, and other gastrointestinal effects. Similarly, AIDS "wasting syndrome"
can literally starve an individual to death.

Investigations with cannabis have revealed its ability to reduce (or eliminate) the
nausea and vomiting associated with chemotherapy while also providing an appetite
stimulus. The benefits are thus twofold: 1) the patient is able to retain food and
maintain body strength, and 2) he or she can tolerate the life-prolonging chemotherapy
treatments.

At least eight published studies have confirmed the ability of cannabis and its
psychoactive ingredient delta-9-THC to reduce nausea and vomiting. The first appeared in
1975 in The New England Journal of Medicine. It concluded, "THC is an
effective anti-emetic for patients receiving cancer chemotherapy."

The Food and Drug Administration (FDA), in February, 1980 listed 33 studies of cannabis
and nausea and vomiting. Most of these experiments involve efforts to determine the proper
dosage of THC and several are comparative studies with other standard anti-emetics.

In New Mexico, a state sponsored study has shown the cannabis cigarette to be 30% more
effective than THC in relieving nausea and vomiting. Another study, sponsored by the
National Cancer Institute (NCI), discovered that inhaled cannabis resulted in a 71%
efficacy rate, as opposed to 44% with oral delta-9-THC. These controlled studies have been
fortified by "anecdotal" accounts from individuals who have abandoned legal
access to THC because they prefer marijuana obtained illegally. These patients report that
smoking marijuana seems to bring an almost instantaneous relief.

This is not a new finding. As early as May 1978, researches at a symposium sponsored by
the National Cancer Institute (NCI) concluded, "All in all, the cigarette may be the
best means of administering the drug."

In September 1988 the chief administrative law judge of the Drug
Enforcement Administration ruled that marijuana has medical value in the treatment of
side-effects caused by cancer chemotherapy. His decision was over-ruled by the
administrator of the DEA and marijuana remains illegal for medical purposes.

Glaucoma is an eye disease which afflicts more than four million Americans and is the
leading cause of blindness in the United States. According to the National Society for
Prevention of Blindness, there are 178,000 new cases of glaucoma diagnosed each year.

Glaucoma can strike people of all ages but is most often found among those over 65. The
most common form of glaucoma is chronic or open-angle glaucoma. It is characterized by
increased pressure within the eye (intraocular pressure or IOP) which can cause damage to
the optic nerve if not controlled effectively. Other types of glaucoma include
narrow-angle and secondary. Treatment of narrow-angle glaucoma is primarily surgical. In
approximately 90% of the open-angle and secondary glaucomas topical (eyedrop) preparations
along with some oral medications can effectively control the disease, but at least 10% of
all cases fail to be completely controlled by available prescriptive drugs. In some
instances available glaucomic medications can cause side-effects such as headaches, kidney
stones, burning of the eyes, blurred vision, cardiac arrhythmias, insomnia, and nervous
anxiety. These side-effects may become so severe that the patient must discontinue use.

Marijuana has shown promise as a possible glaucoma treatment in numerous published studies. In controlled studies at
UCLA, it was discovered that patients smoking marijuana experienced, on average, a 30%
drop in eye pressure. The reduction was dose related and lasted 4 to 5 hours. Dr. Robert
Hepler, principal investigator in the UCLA study, concluded that cannabis may be more
useful than conventional medications and may reduce eye pressure in a way that
conventional medications do not, thus making marijuana a potential additive to the
glaucoma patient's regimen of available medication.

Tolerance to conventional medications is a common problem in glaucoma control. The use
of marijuana for additional IOP reduction could eliminate the need for surgical
intervention. Glaucoma surgery costs Americans an estimated $8.8 million per year.

Scientists have been working to develop a marijuana eyedrop for several years. Until
recently, they concentrated on delta-9-THC, marijuana's psychoactive ingredient. Some
researchers, however, have begun to wonder if other constituents in the cannabis plant
might be more effective in reducing IOP. This theory is bolstered by the few glaucoma
patients who have continued, legal access to marijuana. In these cases, synthetic THC is
only effective for a short period of time. Natural marijuana, however, consistently lowers
IOP.

A number of pharmaceutical companies are investigating drugs that are chemically
similar to various constituents of cannabis for possible glaucomic applications. A West
Indies pharmaceutical company has developed a synthetic marijuana eyedrop but this is
unavailable in the U.S.

Cannabis (marijuana) has demonstrated particular success in the treatment of muscular
spasticity disorders.

In 1839, Dr. William B. O'Shaughnessy was greatly impressed with the plant's muscle
relaxant and anti-convulsant properties, stating his belief that in cannabis, "The
(medical) profession has gained an anti-convulsive remedy of the greatest value."

An historical account alluding to the use of cannabis in the treatment of spasticity
can be found in a March 22, 1890, issue of The Lancet. An article written by Dr.
J. Russell Reynolds (physician to Queen Victoria) noted, "There are many cases of so
called epilepsy in adults but which, in my opinion (are) the result of organic disease of
a gross character in the nervous centers, in which India hemp (cannabis) is the most
useful agent with which I am acquainted." Dr. Reynolds may well have been referring
to multiple sclerosis (MS). The first written record of MS is noted between 1880-85.

Muscular spasticity is a common condition, affecting more than one million persons in
the United States. It afflicts individuals with multiple sclerosis, stroke, cerebral
palsy, paraplegia, quadriplegia, and spinal cord injuries. Current medical therapy is
woefully inadequate for those individuals suffering from spasticity problems.
Phenobarbital and diazepam (Valium) are commonly prescribed drugs but many patients
develop a tolerance to these medications, can become addicted to the drug, or complain of
heavy sedation.

Dunn and Davis reported in a 1974 issue of Paraplegia magazine that ten
patients admitted using marijuana for spinal cord injury, "with perceived decrease in
pain and spasticity." These anecdotal and historical accounts of marijuana's
effectiveness in treating spasticity have led to a few controlled studies. Dr. Denis Petro
and Dr. Carl Ellenberger completed a pilot study of the effects of delta-9 THC on multiple
sclerosis patients in 1979. Seven of nine patients responded favorably to treatment with
delta-9-THC. Dr. Petro reports hearing from more than one hundred individuals with
spasticity problems who report relief from the use of marijuana.

The continued classification of marijuana as a Schedule I drug has greatly
impeded research with the drug. Nevertheless, a
significant number of studies have been conducted leading Chief Administrative Law
Judge Francis Young of the DEA to conclude in September 1988 that marijuana's medical
benefits in the treatment of spasticity is "beyond question" and recommended
rescheduling of the drug to allow prescriptive access. Unfortunately Judge Young's ruling
was rejected by the administrator of the DEA.